The NHA Annual Report 2025-26 also acknowledged delays in claims processing under Ayushman Bharat PM-JAY

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Private hospitals in Haryana, Punjab and Himachal Pradesh have raised concerns over the functioning of the Ayushman Bharat scheme, flagging problems ranging from prolonged delays in reimbursement to steep deductions from claims and non-payment despite court directions.According to IMA Haryana, around 650 private hospitals in the state were awaiting around ₹1,000-1,200 crore in payments under the scheme, while in Punjab, hospitals alleged that insurance companies were deducting a significant portion of their claims. In Himachal, private hospitals said payments under both the state’s Himcare scheme and Ayushman Bharat had remained pending for prolonged periods, with hospitals in some districts stopping services altogether.The NHA Annual Report 2025-26 also acknowledged delays in claims processing under Ayushman Bharat PM-JAY, including pending verifications and unresolved grievances holding State Health Agencies responsible for claims processing and provider payments.Payment CrisisIn Haryana, Dr Ajay Mahajan, president of the Haryana Indian Medical Association (IMA), said the payment crisis had worsened after the state expanded coverage through its Chirayu scheme in October 2022, bringing more beneficiaries into the programme without a corresponding increase in budgetary allocations.“When the number of beneficiaries increased exponentially, the government also needed to increase its budget. But they did not increase the budget at that speed,” Mahajan said.According to Mahajan, payments that were earlier generally made within seven to 15 days began getting delayed from 2023. The IMA first approached the Haryana government in July 2023 and again in January 2024. Many private hospitals eventually suspended services under the scheme in April 2024, he said.The situation continued despite assurances and payments made by the state government at various points. Mahajan said hospitals again had to shut services for around 18-19 days in August 2025 as mounting dues made it difficult for hospitals to pay salaries and vendors.Empanelled HospitalsHe said many hospitals had also surrendered their empanelment under the scheme. The number of empanelled hospitals in Haryana had fallen from around 660 at the end of 2024-25 to about 480-500 currently, he said.On Tuesday, private hospitals in Haryana suspended Ayushman Bharat services for 24 hours.Mahajan attributed the crisis to inadequate budgetary allocation as well as delays in processing claims. Haryana spent around ₹1,800 crore under the scheme in 2024-25, he said, but budgeted only ₹900 crore for 2025-26 and ₹700 crore for the current financial year.In Punjab, the concern among private hospitals is not currently delayed payment but deductions from claims, according to Dr Divyanshu Gupta, State Secretary of the Private Hospitals and Nursing Homes Association (PHANA), Punjab.“The payment is not a problem but the deduction is the problem,” Gupta said.Rejection RateHe alleged that insurance companies were deducting around 20 per cent of claims on average. He said a hospital raising a claim of ₹10 lakh could see around ₹2 lakh deducted. Gupta claimed that the rejection rate in Punjab was around 20 per cent, compared with what he described as a national average of 1-3 per cent.He said claims were often approved at the pre-authorisation stage but deductions were subsequently made when payments were released. PHANA estimated that around ₹200-300 crore was currently outstanding across hospitals in Punjab.Uncleared DuesHimachal Pradesh, meanwhile, has been facing a prolonged payment crisis involving both its state-funded Himcare scheme and Ayushman Bharat, according to Dr Dinesh Bedi, a private hospital owner in the state.He said the Himachal Pradesh High Court on July 21 directed the authorities to clear the payments but the deadline had passed without dues being cleared.Bedi said the last payment to private hospitals under Ayushman Bharat in the state had been made in January and several hospitals had subsequently stopped providing services. In Kangra, he said, private hospitals had stopped services under the scheme.He also alleged that the state government had failed to release its share of funds under Ayushman Bharat despite the Centre releasing its contribution. Published on September 2, 2026